3/15/2023 0 Comments A fib vs a flutter![]() The presence or absence of risk factors for stroke is used to estimate the risk of stroke in order to determine whether anticoagulation is indicated for paroxysmal or persistent atrial fibrillation. Therapy for conditions that are associated with a risk of atrial fibrillation, including hypertension, hyperlipidemia, diabetes mellitus, sleep apnea, obesity, and excessive alcohol consumption, may reduce the risk of recurrence of atrial fibrillation. How would you evaluate and treat this patient? The Clinical ProblemĪtrial fibrillation is associated with underlying heart disease and with increased risks of death, stroke, heart failure, and dementia. Electrocardiographic (ECG) evaluation shows atrial fibrillation, normal QRS complexes, and a ventricular rate of 110 beats per minute. On physical examination, the body-mass index (BMI the weight in kilograms divided by the square of the height in meters) is 29, the blood pressure is 142/88 mm Hg, the pulse is irregular at 120 beats per minute, and there are irregular first and second heart sounds. He reports that 3 months earlier he began noticing occasional dyspnea on climbing stairs, and this symptom has been persistent for the past month. The article ends with the authors’ clinical recommendations.Ī 63-year-old otherwise healthy man is discovered to have atrial fibrillation during an evaluation for a viral respiratory infection. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. This Journal feature begins with a case vignette highlighting a common clinical problem. The most trusted, influential source of new medical knowledge and clinical best practices in the world. Information and tools for librarians about site license offerings. Valuable tools for building a rewarding career in health care. The authorized source of trusted medical research and education for the Chinese-language medical community. The most advanced way to teach, practice, and assess clinical reasoning skills. Information, resources, and support needed to approach rotations - and life as a resident. The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams. ![]() NEW! Peer-reviewed journal featuring in-depth articles to accelerate the transformation of health care delivery.Ĭoncise summaries and expert physician commentary that busy clinicians need to enhance patient care. ![]() NEW! A digital journal for innovative original research and fresh, bold ideas in clinical trial design and clinical decision-making. ![]()
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